title: Time-in-a-bottle (TIAB): a longitudinal, correlational study of patterns, potential predictors, and outcomes of immunosuppressive medication adherence in adult kidney transplant recipients.
abstract: This study examined patterns, potential predictors, and outcomes of immunosuppressive medication adherence in a convenience sample of 121 kidney transplant recipients aged 21 yr or older from three kidney transplant centers using a theory-based, descriptive, correlational, longitudinal design. Electronic monitoring was conducted for 12 months using electronic monitoring. Participants were persistent in taking their immunosuppressive medications, but execution, which includes both taking and timing, was poor. Older age was the only demographic variable associated with medication adherence (r = 0.25; p = 0.005). Of the potential predictors examined, only medication self-efficacy was associated with medication non-adherence, explaining about 9% of the variance (r = 0.31, p = 0.0006). The few poor outcomes that occurred were not significantly associated with medication non-adherence, although the small number of poor outcomes may have limited our ability to detect a link. Future research should test fully powered, theory-based, experimental interventions that include a medication self-efficacy component.
authors.affiliation: School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA; Research Service, Harry S. Truman Memorial Veterans Hospital, Columbia, MO, USA.
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Russell
authors.forename: Catherine
authors.initials: C
authors.lastname: Ashbaugh
authors.forename: Leanne
authors.initials: L
authors.lastname: Peace
authors.forename: Muammer
authors.initials: M
authors.lastname: Cetingok
authors.forename: Karen Q
authors.initials: KQ
authors.lastname: Hamburger
authors.forename: Sarah
authors.initials: S
authors.lastname: Owens
authors.forename: Deanna
authors.initials: D
authors.lastname: Coffey
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Webb
authors.forename: Donna
authors.initials: D
authors.lastname: Hathaway
authors.forename: Rebecca P
authors.initials: RP
authors.lastname: Winsett
authors.forename: Richard
authors.initials: R
authors.lastname: Madsen
authors.forename: Mark R
authors.initials: MR
authors.lastname: Wakefield
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D011379:Prognosis; D013997:Time Factors; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents
keywords: adherence; kidney; outcomes; patient compliance; transplant